Friday, 28 February 2020

China manufactures the bulk of personal protective equipment used by healthcare providers in the United States. Other countries supplies these equipments are also hit hard by the coronavirus. Healthcare organizations in the United States typically buy more than 2 million N95 masks each month. The shortage of available capacity for production due to factory closures can result in a month long delay in the delivery of N95 marks that are used to protect against the spread of airborne illness. These masks differ from the standard surgical masks as they effectiveness depends on they proper fit and use. Healthcare workers are expected to be trained in the Occupational Safety and Health Administration’s protocols for their use.

In the U.S. only two companies, 3M and Prestige Ameritech, manufacture the full line of N95 respirators. Historically the production of these masks within the U.S. has been insufficient to cover domestic demand. While the two companies are ramping up the production, it is expected to take up to a month to catch up with the demand surge.

On February 26 the U.S. Health and Human Services (HHS) secretary Alex Azar reported to the House Appropriation Committee that U.S. has a stockpile of 12 million N95 masks. However, HHS estimated that we will need 300 million masks to cover an emergency and the combined production capacity in the U.S. and Mexico is only 65 million.

To address this gap between demand and supply, measures such a limiting the use of these masks by only healthcare staff who are directly involved in patient care is needed.

In addition to the surgical masks, the capacity shortage is also going to hit pharmaceutical products and medical devices. China produces 100% of the active pharmaceutical ingredients (APIs) for two vital products - penicillin and blood-thinner heparin. Capacity constraints and disruptions in the shipment of these drugs from China will necessitate exploration of alternative options. Food and Drug Administration (FDA) identified 20 drug products that are linked to China through API sourcing or product manufacturing, although these products are currently not in short supply.

From a supply chain management perspective, the disruption caused by coronavirus has resulted in a call for setting an industry-wide higher expectations with suppliers to improve supply disruption notification process, as noted by Chaun Powell, group vice president for strategic supplier engagement with Premier Inc. One could see potential price increases due to the an expanded base for manufacturing critical healthcare products in an effort to limit shortages of medical supplies. Inventory management practices should consider having safety stock in excess of 20% over the peak usage for these critical supplies, asserts Scott Cormier, vice president of emergency management, environment of care and safety for Medxcel. However, Powell notes that the increase in inventory should be gradual so as to avoid putting additional burden on suppliers.

Tuesday, 14 January 2020

Based on the information that the World Health Organization (WHO) received from the National Health Commission on 11th and 12th January, it was highly suggestive that the outbreak is associated with exposures in one seafood market in Wuhan. 41 confirmed cases were noted and there was one death. China shared the genetic sequence of the novel coronavirus on 12th January, which can help other countries develop diagnostic kits. The cluster was initially reported on 31 December 2019, when the WHO China Country Office was informed. The Chinese authorities identified a new type of coronavirus (novel coronavirus, nCoV), which was isolated on 7 January 2020. Laboratory testing was conducted on all suspected cases identified through active case finding and retrospective review. Other respiratory pathogens such as influenza, avian influenza, adenovirus, Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome coronavirus (MERS-CoV) were ruled out as the cause.

The clinical signs and symptoms reported are mainly fever, with a few cases having difficulty in breathing, and chest radiographs showing invasive pneumonic infiltrates in both lungs. National authorities report that patients have been isolated and are receiving treatment in Wuhan medical institutions. According to the preliminary epidemiological investigation, most cases worked at or were handlers and frequent visitors to the Huanan Seafood Wholesale Market. The government reports that there is no clear evidence that the virus passes easily from person to person.

The following public health response measures were taken:

A total of 763 close contacts including healthcare workers, have been identified and followed up and no additional cases of infection with the novel coronavirus have been identified;

The Wuhan Municipal Health Commission carried out active case finding, and retrospective investigations of the current cluster of patients have been completed

The Huanan Seafood Wholesale Market has been temporarily closed to carry out environmental sanitation and disinfection;

Public risk communication activities have been carried out to improve public awareness and adoption of self-protection measures.

Monday, 16 December 2019

It was an enlightening and inspiring experience visiting and witnessing success stories of student-led consulting projects in underprivileged communities (villages) in Panama. These projects are facilitated by Global Brigades, an international non-profit that uniquely implements a holistic model to meet a community’s health and economic goals. The projects include establishment of internationally recognized community-owned banks in some of the country’s most under resourced, rural communities, micro-financing ventures created and run by indigenous tribes, helping these ventures succeed by offering hands-on business solutions, and providing healthcare to underprivileged communities.